Treatment for Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic disease, which affects the lining or the synovium of the joints, causing inflammation. This results in pain, swelling, stiffness, and loss of function in the joints. The major considerations in the treatment of rheumatoid arthritis are to relieve pain, reduce inflammation and slow down or stop joint damage.

The approaches used for the treatment of rheumatoid arthritis vary from person to person. The treatment methods involved can be classified as followed

I. Non-surgical procedures

a. Medication

b. Self-management techniques

c. Alternative therapy

II. Surgical procedures

a. Joint replacement

b. Tendon reconstruction

c. Synovectomy

Depending on the patient different combinations of these methods are used for treatment.

Drugs used in the treatment of rheumatoid arthritis

The drugs used for the treatment of rheumatoid arthritis can be classified into three groups. They are

i. Pain relieving drugs

Analgesic Drugs or pain relieving drugs reduces the pain caused the disease. Examples of the analgesic drugs include acetaminophen, propoxyphene, mepeidine and morphine. The other groups of drugs that are also used for pain relief are the Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).NSAIDs can also reduce inflammation. Some of the NSAIDs include aspirin, ibuprofen, indomethacin and COX-2 inhibitors such as valdecoxib and celecoxib.

ii. Inflammation reducing drugs

Inflammation reducing drugs or anti-inflammatory drugs decrease inflammation and suppress the immune system and. Example for anti-inflammatory drugs includes the corticosteroids such as prednisone, cortisone, methylprednisolone, and hydrocortisone. Corticosteroids can be administered either orally or through injections. Corticosteroids administered orally for a prolonged period with a high dosage can cause brittle bones, cataracts, elevated blood sugar, and an increased susceptibility to infections throughout the body.

iii. Disease-modifying anti-rheumatic drug (DMARD)

The drug that comes under this group tends to slow or stop disease progress and prevent disability and discomfort. Examples of DMARD include injectable gold, penicillamine, azathioprine, chloroquine, hydroxychloroquine, oral gold, rheumatrex (methotrexate), azulfidine (sulfasalazine), and arava (leflunomide).Administration of DMARD in an earlier stage can help prevent irreparable joint damage.

Biological products or biologics are a new class of drugs used for the treatment of rheumatoid arthritis. They are obtained from living sources. The four licensed biologics that are in use includes enbrel (etanercept), remicade (infliximab) and humira (adalimumab) and kineret (anakinra).

Self-management techniques

Rheumatoid arthritis can be kept under control by maintaining rest and exercise balance, reducing stress, providing proper joint care, maintaining healthy diet and using alternative treatments along with medications. Alternative therapy Alternative therapy includes massage, acupuncture and acupressure special diets, herbs and Supplements. Surgical procedures

The commonly performed surgical procedures include

I. Joint replacement

Joint replacement is the most frequently performed procedure. This procedure involves the removal of the joint, resurfacing and relining of the ends of bones and replacing the joint with artificial joint.

II. Tendon reconstruction

Tendons are the tissues that attach muscle to bone. Tendon reconstruction is frequent in case of the occurrence of rheumatoid arthritis in hand. This procedure is done by reconstructing the damaged tendon by attaching an intact tendon to it. This procedure helps to restore hand function, especially if the tendon is completely ruptured.

III. Synovectomy

Synovectomy is the removal of the damaged synovial tissue. The major drawback in this procedure is that the synovial tissue cannot be removed completely and also the tissue is capable of regeneration.